By early summer, four communities in Colorado will be able to securely share patient information through the Colorado Regional Health Information Organization's (CORHIO) network. The signed agreements for the seven hospitals, nine medical practices and four community mental health centers represent an acceleration of the nonprofit's health information exchange (HIE) goals.

CORHIO, a public-private partnership focused on improving healthcare quality for Coloradoans and also the designated entity to facilitate statewide HIE, began its community outreach and education program in 2008 and expected to work with a couple of communities first to demonstrate the value of HIE and then move to other communities.

The "blessing and the curse" of the American Recovery and Reinvestment Act's HITECH Act of 2009 was the awareness and understanding of HIE among communities across the state and their eagerness to participate, said executive director Phyllis Albritton. "They understand the value of health information exchange as a community effort to transform care in the state of Colorado," she said.

The first group of participants is currently working through technology issues in preparation to go live. The next step for the public-private partnership is to continue to build community-based coalitions, expand community capacities and expand its scope of services, she said. In January 2011, CORHIO was awarded a $1.7 million Challenge Grant by the Office of the National Coordinator for breakthrough innovation in HIE. CORHIO will focus on improving long-term and post-acute care transitions.

Boulder Community Hospital is the first hospital able t send patient data, and will be connected with the other six hospitals and more than 200 healthcare providers this year through its HIE platform by Medicity. Six of the seven hospitals represent either 50 percent or 100 percent of the market in their communities. CORHIO anticipates signing more agreements with healthcare providers in other communities soon, Albritton said.

CORHIO's Colorado Health Foundation grant is enabling the state-designated entity to go beyond the HITECH Act's reach of eligible hospitals and physicians, and encompass all community participants, including community mental health centers, where the value proposition for the whole community is at stake, she said.
"Our mission and our goal is to work with communities from the bottom up," Albritton said. "In some communities, we helped develop the 'community place' where providers came together and we partnered with local communities to make that happen." In other instances, forward-thinking communities reached out to CORHIO to help them go beyond their HIE discussions and for collaboration.

Colorado healthcare providers overall have made early investments in healthcare IT. Typical traits of the seven hospitals are having involved CIOs and the incorporation of healthcare IT to improve quality of care within their organizations, Albritton pointed out. All mental health centers and all but two of the federally qualified health centers in Colorado have had EHRs for many years.

It's still a struggle for safety-net providers because of limited resources, she said. "I give the safety-net community in the state of Colorado a lot of credit for being ahead of the curve in that regard. They are probably ahead of where many of the private practitioners in the state are and are able to work within this community framework to help other practitioners understand the value proposition of health information technology." CORHIO tries to bring everybody to the table because the value of HIE isn’t there unless the whole community is involved, Albritton emphasized.

How did many healthcare providers in the state reach this understanding of healthcare IT? Albritton said a number of factors have led to this "perfect storm." Colorado's communities have historically struggled with a healthcare workforce shortage and saw a value proposition in technology assisting the workforce at a lower cost. Many practitioners in the state are also involved in quality initiatives and through training have understood the value of interconnection with providers in neighborhood communities to manage population health, she said.

By 2015, every community in Colorado will be expected to have HIE capabilities, whether CORHIO or Quality Health Network, the nonprofit quality improvement collaborative located in Grand Junction, is providing it, Albritton said. In all those communities, 85 percent of all providers are expected to be meaningful users of EHRs.